CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:An orthogonal IL-2 and IL-2Rβ system drives persistence and activation of CAR T cells and clearance of bulky lymphoma.
An orthogonal IL-2 and IL-2Rβ system drives persistence and activation of CAR T cells and clearance of bulky lymphoma.
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嵌合抗原受体(CAR)T细胞可在难治性血液肿瘤患者中诱导持久缓解。然而,CAR-T 细胞活性低、植入不良或体内持久性短可导致肿瘤进展或复发。
此外,CAR-T 细胞过度扩增和活化可导致危及生命的细胞因子释放综合征(CRS)。因此,对体内CAR-T 细胞群体进行控制至关重要。白细胞介素-2(IL-2)是T细胞增殖和效应功能的关键细胞因子,但其临床应用受到免疫介导毒性的限制。
在此,我们报告了一种正交IL-2受体和配体系统,可实现对CAR-T 细胞扩增和活化的特异性体内控制,其中正交人IL-2(STK-009)选择性地与表达于CAR-T 细胞上的正交人IL-2R(hoRb)配对。STK-009在存在和不存在肿瘤抗原的情况下均可扩增表达hoRb的CAR-T 细胞,并维持干细胞记忆T细胞(T SCM)和效应T细胞的存在。在人CAR难治性淋巴瘤的临床前模型中,STK-009治疗导致表达hoRb的抗CD19-CD28 CAR-T 细胞(SYNCAR)在全身和瘤内扩增和活化。正交IL-2受体/配体系统通过选择性体内扩增和活化CAR-T 细胞,即使CAR-T 细胞剂量大幅降低,也可在大型皮下淋巴瘤中实现完全缓解。停用STK-009可使CAR-T 细胞正常收缩,从而限制由肿瘤抗原特异性T细胞活化诱导的CRS。这些数据表明,正交IL-2受体/配体系统提供了最大化CAR-T 疗法疗效所需的体内控制。
Chimeric antigen receptor (CAR) T cells induce durable responses in patients with refractory hematological tumors.
However, low CAR T cell activity, poor engraftment, or short in-patient persistence can lead to tumor progression or relapse.
Furthermore, excessive CAR T cell expansion and activation can result in life-threatening cytokine release syndrome (CRS).
Thus, in-patient control of the CAR T cell population is essential. Interleukin-2 (IL-2) is a critical cytokine for T cell proliferation and effector function, but its clinical use is limited by immune-mediated toxicity.
Here, we report on an orthogonal IL-2 receptor and ligand system that enables specific in vivo control of CAR T cell expansion and activation, wherein an orthogonal human IL-2 (STK-009) selectively pairs with an orthogonal human IL-2R (hoRb) expressed on CAR T cells. STK-009 expands hoRb-expressing CAR T cells in the presence and absence of tumor antigen and maintains the presence of stem cell memory T cells (T SCM ) and effector T cells. In preclinical models of human CAR-refractory lymphoma, STK-009 treatment resulted in systemic and intratumoral expansion and activation of hoRb-expressing anti CD19-CD28 CAR T cells (SYNCAR).
The orthogonal IL-2 receptor/ligand system delivers complete responses in large subcutaneous lymphomas, even with substantially reduced CAR T cell doses, by selectively expanding and activating CAR T cells in vivo. STK-009 withdrawal allowed normal CAR T cell contraction, thereby limiting CRS induced by tumor antigen specific T cell activation. These data suggest that the orthogonal IL-2 receptor/ligand system provides the in vivo control necessary to maximize efficacy of CAR T therapies.
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